2005年心肺复苏指南在中国急诊医学书籍中内容更新的调查

摘要

Objective To investigate if the update of cardiopulmonary resuscitation in Chinese Emergency medicine books can keep pace with the international cardiopulmonary resuscitation research.Methods To design the questionnaire according to the standard of 2005 American Heart Association CPR guidelines.To investigate and analyze the items of CPR in the emergency medicine books, which were published from March 2006 to December 2009 in China.Results This study investigated and analyzed 45 emergency medicine books from 23 publishers.The basic integrity of CPR in the books published in 2008 ～2009 (81.8％ ) was better than that in 2006 ～2007 (34.8％).But the systemic integrity and errors were same between different years, there was no significant difference.The errors were almost existed in every parts of CPR, mainly in three areas: ①Still followed the 2000 CPR guidelines; ② Some special methods in China; ③It was inconsistency or ambiguous at the same point.The highest error rates are: volume of artificial ventilation (61.5％), check for response (50.0％),location of chest compressions (45.0％) and time of breath checking (43.5％).Conclusion There was great improvement of emergency medicine textbooks, but it still needs more improvement of details.It had failed to do timely and completely the update in the international CPR guidelines, and still had some outdated knowledge.%目的 探讨中国急诊医学书籍中关于心肺复苏术内容的更新程度能否跟上国际心肺复苏研究的步伐.方法 以2005年美国心脏协会心肺复苏术指南中的知识点为标准,自行设计调查表,对2006年3月至2009年12月期间中国出版的,针对专业医务人员的急诊医学书籍中心肺复苏术操作描述进行调查分析.结果 本次研究调查分析了自全国23个出版社的45本针对专业医务人员的急诊医学书籍.在心肺复苏术基本操作流程的完整性上,2008～2009年出版的书籍(81.8%) 高于2006～2007年出版的书籍 (34.8%),差异有统计学意义.而在系统完整性和未更新的知识数量上不同年份间比较差异无统计学意义.其中未更新的知识点几乎存在于心肺复苏术操作的每个环节,主要集中体现在以下三方面:①仍延用2000年心肺复苏术指南中的操作标准或更早的标准;②国内的一些特殊方法;③同一知识点描述的前后矛盾或含糊不清.其中未更新率最高的四项操作依次是:人工呼吸通气量 (61.5%)、判断意识方法(50.0%)、胸外按压定位(45.0%) 和判断呼吸时间(43.5%).结论 中国急诊医学书籍的整体编写质量上有了很大的提高,但细节上仍有待进一步完善,特别是在对国际心肺复苏术指南的更新程度上并没有做到及时和完整,仍有较多未更新的知识点存在.